Allogeneic hematopoietic stem cell transplantation (alloHCT) remains the best treatment for a broad range of hematologic diseases. The field has seen remarkable advances in the past two decades, with improved outcomes and access to transplantation, especially for patients who are older or from minority communities historically underrepresented in transplant registries.
For the first time in history, nearly all patients who require alloHCT have one or more potential donors available, including matched related and unrelated donors, umbilical cord grafts, and haploidentical family members. Unfortunately, many primary hematologists and transplant specialists find this multiplicity of options confusing or intimidating, and they are finding it more difficult than ever to counsel patients about which transplant path is best.
The development of reduced-intensity and nonmyeloablative conditioning has also made it increasingly possible to perform alloHCT in older patients, with overall survival rates steadily improving. Most centers are now comfortable transplanting selected septuagenarians following comorbidity screening. Despite these advances, population studies demonstrate that even for widely supported indications (e.g., autologous HCT for myeloma and alloHCT for high-risk acute myeloid leukemia) only a minority of suitable patients ever reach a transplant. Thus, the issue of barriers to transplant remains a critical problem. This spotlight session will highlight these critical issues of donor graft selection and the barriers that limit transplant access and utilization.
Dr. Daniel Weisdorf will discuss the array of donor and graft choices available for alloHCT recipients and discuss principles that should govern clinical decision making.
Dr. Navneet Majhail will place recent advances in the context of remaining barriers to HCT that can be improved by coordinated efforts of referring hematologists and HCT clinicians.
Navneet S. Majhail
Daniel J. Weisdorf
Active, International, Emeritus, and Honorary Members
Associate, International Associate, Student, and Resident Members